Adjunct to diet & exercise to improve glucose control in patients w/ type 2 DM. Monotherapy & combination therapy w/ sulfonylurea or metformin if diet & exercise along w/ one of these medications do not provide adequate blood glucose control. Combination therapy w/ metformin & sulfonylurea if dual combination therapy does not provide adequate glycemic control (especially in overwt patients).
Dosage/Direction for Use
Monotherapy: Initially 15 or 30 mg once daily. Gradually increase the dose to 45 mg once daily. Combination therapy: Initially 15 or 30 mg once daily. Metformin & sulfonylurea doses may be continued after initiating therapy. If hypoglycemia occurs, reduce the dose of sulfonylurea.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity. Patients w/ heart failure or a history of heart failure (NYHA stage I-IV), kidney damage, diabetic ketoacidosis, bladder cancer or history of bladder cancer. Patients using insulin.
Special Precautions
Discontinue use if ALT levels increase 3x ULN. Fluid retention & heart failure. Monitor liver enzymes. Strictly control calorie intake. Risk of hypoglycemia in combination w/ sulfonylurea. Not recommended in patients <18 yr.